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颞叶白质纤维解剖学及神经影像学研究

发布时间:2018-06-05 23:12

  本文选题:Klingler技术 + DTI ; 参考:《宁夏医科大学》2009年硕士论文


【摘要】: 目的运用Klingler解剖技术及DTI技术,对颞叶区域白质纤维结构进行研究,为选择手术入路,减少神经损伤提供科学依据。 方法1.运用Klingler解剖技术,将10例成人头颅湿标本进行福尔马林固定和冰冻,后在×4~25倍的手术显微镜下,对颞叶区域各白质纤维结构进行逐层分离,并注意观察和测量。2.运用DTI技术对10名健康志愿者应用DTI技术行脑白质纤维成像,对颞叶的重要白质纤维束应用解剖学知识基础上的多兴趣区方法进行重建。3.结合Klingler解剖技术和DTI技术,对视辐射进行对比研究。 结果1.运用Klingler解剖技术可清晰显示颞叶区域各白质纤维结构:弓状束、外囊、屏状核、下纵束、钩状束、额枕下束、视辐射、前联合等纤维束的解剖结构和位置。2.运用DTI技术可清晰显示颞叶区域重要白质纤维结构:颞干,其由钩状束、前连合、额枕下束、视辐射、丘脑下脚构成。它开始于岛阈,结束于岛叶后下点,其长度平均为33.5mm(30~40 mm)。钩状束和前连合占据颞干前1/3,额枕下束走行于全部颞干,视辐射的大部走行于颞干的后2/3。3.结合Klingler解剖技术和DTI技术,视辐射的结构在解剖和DTT上显示是一致的,其由外侧膝状体发出分三束覆盖于颞角前极外侧半、全部颞角上壁及外侧壁,Meyer袢走行于颞角顶壁,并超过颞角尖部前方平均2.1mm(1~3mm)。经侧裂入路的颞叶手术中,在外侧裂底部存在着一个可以避免损伤视辐射进入颞角的安全三角区域(岛阈或下环岛沟周围5mm范围内垂直进入颞角不会损伤视辐射),而在其后10、15、20mm水平处切口,向内下与矢状面成一定的角度可避免损伤视辐射。 结论1.运用Klingler解剖技术及在解剖基础上的DTI技术可清晰显示颞叶区域重要纤维结构和位置关系。2.颞干的基本构筑是相同的,但颞干的大小及形态也存在明显的个体差异性。岛阈、颞角前极和岛叶后下点可以被用于对颞干在MR或手术中定位。3.视辐射走行于颞角顶壁,并超过颞角尖,到达颞角与颞极之间。经侧裂进入颞角的手术,切口靠近岛阈或下环岛沟周围5mm范围对视辐射的损伤机会小。
[Abstract]:Objective to study the structure of white matter fibers in temporal lobe using Klingler anatomical technique and DTI technique in order to provide scientific basis for selecting operative approach and reducing nerve injury. Methods 1. Using Klingler anatomical technique, 10 adult head wet specimens were fixed and frozen with formalin, then the white matter fiber structure in temporal lobe was separated layer by layer under a 25 times operation microscope, and observed and measured. DTI technique was used to reconstruct the important white matter fiber bundle of temporal lobe by DTI technique in 10 healthy volunteers. Combined with Klingler anatomical technique and DTI technique, a comparative study of visual radiation was carried out. Results 1.Results 1. By using Klingler anatomical technique, the structures of white matter fibers in temporal lobe area can be clearly displayed: arcuate bundle, outer capsule, palmatoid nucleus, inferior longitudinal bundle, hook bundle, frontal suboccipital bundle, visual radiation and anterior syndesmosis. Using DTI technique, the important white matter fiber structure in temporal lobe region can be clearly displayed: temporal trunk, which is composed of uncinate fascicle, anterior junction, frontal suboccipital tract, visual radiation and hypothalamic foot. It begins at the island threshold and ends at the lower point behind the islet, with an average length of 33.5mm(30~40. A third of the temporal trunk was occupied by the uncinate bundle and the anterior conjunction. The frontal and occipital bundles were located in all the temporal trunks, and the majority of the apparent radiation was in the posterior 2 / 3.3 of the temporal trunk. Combined with Klingler anatomical technique and DTI technique, the structure of visual radiation was identical in anatomy and DTT. It was covered by three beams of lateral geniculate body on the lateral side of the anterior pole of the temporal horn. All the superior and lateral walls of the temporal horn and the lateral wall of Meyer's loop walked along the parietal wall of the temporal horn. And above the tip of the temporal horn, the average was 2.1 mm and 3 mm above the anterior part of the temporal horn. In temporal lobe surgery via lateral fissure approach, At the base of the lateral fissure, there is a safe triangular region (island threshold or vertical entry into the temporal horn within the range of 5mm around the lower circumferential sulcus) that can avoid the injury of visible radiation into the temporal horn, but an incision at the level of 1015mm or 20mm is not damaged at the bottom of the lateral fissure. The damage to visual radiation can be avoided at a certain angle between the inward and sagittal plane. Conclusion 1. Using Klingler anatomical technique and DTI technique on the basis of anatomy can clearly display the important fibrous structure and position relation of temporal lobe. The basic construction of the temporal trunk is the same, but the size and shape of the temporal trunk also have obvious individual differences. The island threshold, the anterior temporal horn and the posterior inferior point of the insular lobe can be used to locate the temporal trunk on Mr or during surgery. The visible radiation travels along the parietal wall of the temporal horn and above the tip of the temporal horn, reaching between the temporal horn and the temporal pole. Through lateral fissure into the temporal horn, the incision near the island threshold or the 5mm area around the inferior island groove has little chance of damage to visual radiation.
【学位授予单位】:宁夏医科大学
【学位级别】:硕士
【学位授予年份】:2009
【分类号】:R651;R322

【参考文献】

相关期刊论文 前1条

1 陈桂生,戴秀英,孔繁元,许兆礼,赵新民,訾秀娟,王文志,吴建中;WHO/IEM/ILAE全球抗癫痫运动—宁夏农村癫痫的流行病学调查[J];中华神经医学杂志;2003年06期



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